MEDICARE: KIDSFIRST PEDIATRICS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1023289550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDSFIRST PEDIATRICS, PLLC

Provider Business Mailing Address
First Line	:	46165 WESTLAKE DR
Second Line	:	SUITE 210
City	:	POTOMAC FALLS
State	:	VA
Zip	:	20165-5872
Country	:	US
Telephone Number	:	703-433-1555
Fax Number	:	703-444-9830

Provider Business Practice Location Address
First Line	:	46165 WESTLAKE DR
Second Line	:	SUITE 210
City	:	POTOMAC FALLS
State	:	VA
Zip	:	20165-5872
Country	:	US
Telephone Number	:	703-433-1555
Fax Number	:	703-444-9830

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PAULA N FERGUSSON
Credential	:	MD
Telephone Number	:	703-433-1555

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	03/12/2008

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